Credit Card Authorisation Form

Completion of Form

Sign and complete this form to authorise Australian Centre for international Commercial Arbitration (ACICA) to make a one time debit to the credit card listed below. By submitting this form you give ACICA permission to debit your account for the amount indicated on or after the indicated date. This is permission for a single transaction only and does not provide authorization for any additional unrelated debits or credits to your account.

Please complete the information below:

I authorize ACICA to charge the credit card indicated in this authorization form according to the terms outlined above. This payment authorization is for the goods/services described in this form, for the amount indicated only, and is valid for one time use only. I certify that I am an authorised user of this credit card and that I will not dispute the payment with my credit card company; so long as the transaction corresponds to the terms indicated in this form. Please note that all credit card payments incur an additional payment processing fee applied by Stripe. The amount of the fee is dependent on the associated credit card and can range from around 1.15% to 3.3%.
Please include a description of the services being paid for and reference the invoice number.
Price: $416.16
Ulrike Gantenberg 2026–2027 Membership fees